Kronik hepatit B hastalarında karaciğer histolojisi ile platelet parametreleri arasındaki ilişki

Yıl 2019, Cilt: 44 Sayı: 4, 1160 - 1166, 29.12.2019

Cihat Çoşgun Alpaslan Karabulut , Barış Yılmaz Hüseyin Köseoğlu Emre Demir

https://doi.org/10.17826/cumj.512080

Öz

Amaç: Karaciğer fibrozis tanı ve skorunun belirlenmesi için birçok noninvaziv test çalışılmıştır. Bu çalışmada, kronik hepatit B (KHB) olan hastalarda platelet parametrelerinin ve karaciğer fibrozisin evresi arasındaki ilişkiyi araştırmayı amaçladık. 

Gereç ve Yöntem: Çalışmaya toplam 140 biyopsi ile kanıtlanmış naiv KHB olgusu dahiledildi. HBV-DNA düzeyi, karaciğer enzimleri ve fonksiyon testleri, beyaz kan hücresi sayısı, platelet parametreleri, hemoglobin, histolojik aktivite indeksi (HAI) ve diğer rutin biyokimyasal parametreler test edildi. Karaciğer biyopsi örnekleri modifiye Ishak skorlama sistemi kullanılarak incelendi. Hastalar karaciğer fibrosis şiddetine göre modifiye İshak puanlama sistemi ile F0-2 ve F3-6 olarak iki gruba ayrıldı.

Bulgular:  F0-2 ve F3-6 grupları arasında platelet (PLT), ortalama platelet hacmi (MPV), platelet dağılım genişliği (PDW) ve platelecrit (PCT) açısından anlamlı fark yoktu. Bu iki grup arasında HAİ, aspartat transaminaz (AST), gama glutamil transaminaz (GGT), yaş ve lenfosit parametreleri açısından anlamlı fark vardı. Karaciğer fibrozis evresini tahmin etmede kullanılmak üzere birçok farklı kombinasyondan oluşan (AST x Yaş x Lenfosit) /√PLT) formülasyonu araştırıldı. 

Sonuç: Yeni indeksimiz diğer noninvaziv skorlama sistemlerine göre daha sensitivitesi yüksek olmakla birlikte noninvaziv belirteç olarak güvenle kullanılabilmesi için ileri karaciğer fibrozis düzeyine sahip olan hastaların daha fazla olduğu, daha geniş örneklem büyüklüğüne sahip çalışmalara ihtiyaç vardır.

Anahtar Kelimeler

Kronik hepatit B, Fibrozis, platelet

Relationship between liver histology and platelet parameters in patients with chronic hepatitis B

Öz

Purpose: Many noninvasive tests have been studied for the diagnosis and determining the liver fibrosis score. In this study, we aimed to research the correlation of platelet parameters and stage of liver fibrosis in patients with chronic hepatitis B (CHB).

Materials and Methods: A total of 140 biopsy-proven naive CHB cases were included in the study. HBV-DNA level, liver enzymes and function tests, white blood cell count, platelet parametres, hemoglobin, histological activity index (HAI) and other routine biochemical parameters were tested. Patients were divided into two groups as F0-2 and F3-6 with Ishak scoring system according to the severity of liver fibrosis.

Results: There was no significant difference between the groups F0-2 and F3-6 in terms of, platelet (PLT), mean platelet volume (MPV), platelet distribution width (PDW) and plateletcrit (PCT). There was a significant difference between these two groups for HAI, aspartate aminotransferase (AST), gamma glutamyl transpeptidase (GGT), age and lymphocyte (LYM) parameters. The formulation of (AST x Age x LYM) / √PLT)which was formed from many different combinations, was investigated in order to be used in predicting the liver fibrosis stage. 

Conclusion: Although our new index is more sensitivitythan other noninvasive scoring systems, it is needed to have a larger sample size in patients with severe stage liver fibrosis in order to be used safely as a noninvasive marker.

Anahtar Kelimeler

Chronic hepatitis B, Fibrosis, Platelet

Kaynakça

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